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Food Safety in Pregnancy

Pregnancy Dr Erin Nesbitt-Hawes Director
There are many dos and don’ts of pregnancy and the majority relate to foods we eat. So what is safe to eat in pregnancy and which foods should we avoid?

Women are often told that they can “eat for two” when they are pregnant, however this is not the case!  A healthy well balanced diet for pregnancy includes daily servings of protein (such as eggs, meat, chicken, fish, tofu or legumes), dairy (milk, yoghurt and cheese), carbohydrates (breads, cereals), fruits and vegetables.  Small amounts of fats and oils as well as “treats” are allowed in moderation, however the latter need to be avoided in certain circumstances such as gestational diabetes.  The information below is adapted from the NHMRC Australian dietary guidelines and gives examples of how many servings to eat per day:

Grain foods (including breads, cereal, rice, pasta, noodles)

Per day = 8½ servings (mostly wholegrain and/or high fibre)

1 serve = 1 slice of bread / ½ medium bread roll or flat bread / ⅔ cup of wheat cereal flakes / ½ cup of cooked rice, pasta, noodles, cous cous or quinoa

Vegetables & legumes

Per day: 5 servings

1 serve = ½ cup of cooked green or orange vegetables / 1 cup of green leafy or raw salad vegetables / ½ cup of cooked, dried or canned beans, peas or lentils / ½ medium starchy vegetable (potato, sweet potato or taro)

Fruit

Per day: 2 servings

1 serve = 1 medium apple or banana / 2 small fruits (apricots, kiwi fruit or plums) / 1 cup of diced or canned fruit (no added sugar)

Protein (meat, fish, poultry, cooked eggs, nuts, legumes)

Per day: 3½ servings

1 serve = 90-100 g raw weight of cooked meat (beef, lamb, pork) / 100 g raw weight of cooked lean poultry (chicken or turkey) / 115 g raw weight of cooked fish fillet or one small can of fish 30g of nuts, seeds or peanut butter / 2 large eggs / 170 g of tofu

Calcium (milk, yoghurt, hard cheese and dairy alternatives)

Per day: 2½ servings (mostly reduced fat)

1 serve = 250 ml of milk (1 cup) / 250 ml of soy, rice or other cereal drink fortified with at least 100 mg per 100 ml calcium 40 g (2 slices) of hard cheese 200 g of yoghurt

Folate:  Folate or folic acid is an important vitamin required in early pregnancy by the developing baby to create a normal spinal cord.  Deficiencies in folate can lead to problems like spina bifida.  As well as consuming green leafy vegetables and foods fortified with folic acid it is recommended that you take a daily supplement of at least 400 mcg/day for one month prior to pregnancy and the first 3 months of the pregnancy to help ensure there is no deficiency.  Some women such as those with a family history of neural tube defects need higher doses of folic acid, so discuss this with your doctor prior to pregnancy to ensure you are on the right dose.

Iodine:  Iodine is an element that is important for normal brain development and cognition.  In Australia, most breads and some salt is fortified with iodine to help reduce the likelihood of deficiencies.  Some of the pregnancy vitamin supplements contain iodine.  Iodine can also be found in green leafy vegetables and foods such as seaweed.  Seaweed contains so much that large quantities can be toxic and it is recommended that pregnant women consume no more than one serving of brown seaweed weekly for this reason.

Iron:  As your baby grows and develops, it requires large quantities of iron and this means that iron deficiency in pregnancy is a common problem.  Iron-rich foods such as meats, poultry, eggs, leafy vegetables and legumes can boost your iron stores.  Iron supplementation is sometimes used under the guidance of your Obstetrician, but be aware, the effects can be very constipating!  There are some supplements that this side effect is not as much of an issue for, so speak to your doctor about the best type for you.  Taking vitamin C at the same time as iron helps to increase the absorption, so it is often recommended that you take the two supplements together.

Meat, poultry and eggs:  Much needed protein and iron are contained in servings of meat and poultry, but during pregnancy it is important to be very careful about how these foods are prepared.  Raw meat and poultry should not be consumed during pregnancy.  Meat should be cooked to medium (71⁰C) and eaten while hot.  Chicken and poultry must be cooked through.  Takeaway hot chicken can be eaten if purchased freshly cooked and eaten while still hot.  It is not recommended that you eat any processed meats (ham, salami, etc) unless cooked thoroughly.  Pâte is off the menu, as are cold chicken and turkey meats from sandwich bars.  Eggs need to be cooked through and eaten while hot.

Seafood:  Raw seafood is not recommended during pregnancy and all fish and seafood should be cooked to at least 63⁰C and eaten while hot.  Leftovers should be stored in the fridge and reheated and eaten within one day.

Fish is an important source of omega 3 fatty acids for your baby’s brain development.  It is important to know the guidelines about eating fish in pregnancy as some fish contain mercury which can be harmful in high levels.  Food standards Australia recommends 2-3 serves per week of any fish except the following:

  • Catfish or Orange Roughy (Deep Sea Perch) which should be only consumed one serve a week (with no other fish);
  • Shark (Flake) or Billfish (eg. Marlin, Swordfish) which should only be consumed one serve per fortnight (and no other fish).

Sushi:  Many women miss eating sushi during their pregnancy but you need not miss out altogether.  If you prepare your own sushi freshly, avoid raw fish and meat and consume it immediately then you can still enjoy this delicious treat safely during pregnancy.

Cheese and Dairy:  Semi-soft and soft cheeses such as ricotta, feta, brie and camembert are best avoided during pregnancy unless they are cooked and eaten soon afterwards.  You can indulge in hard cheeses though such as cheddar and tasty, as long as they are stored in the fridge.

Dairy is an important food which provides you with calcium during the pregnancy.  Calcium ensures strong bones for both you and your developing baby and your stores need to be up to scratch in both the third trimester (when a lot of the baby’s bone development is happening) and when the baby is born (when you are producing calcium rich milk).  If your intake is not enough, the calcium will be taken from your bones increasing the risk of osteoporosis later on.

Fruit and vegetables:  Salad ingredients for a home-made salad should be washed well before use and stored in the fridge.  Steer clear of salads from deli sections or salad bars that have been pre-prepared and can be sitting out for long periods of time.  Fresh fruit and vegetables can be eaten safely raw or cooked as required and help with your fibre intake and “keeping your bowels regular”, an important consideration in pregnancy!  Bean sprouts in any form should be avoided though.

Alcohol:  It is not known what the safe limit of alcohol for the developing baby is, so during pregnancy it is recommended that you do not drink alcohol at all.  Alcohol intake during pregnancy carries the risk of fetal alcohol syndrome (developmental delay) and premature birth.

While this list seems restrictive, the main aim is to keep you and your baby safe and healthy during pregnancy.  It won’t be forever, and after the baby is born you can relax back with a glass of champagne and some double brie  – you will have earned it!

For more information about food safety and pregnancy visit the NSW Food Authority website.